Unit: CPR/AED and 1st Aid

Choking (FBAO)

Key Points-Diaphragm

A dome-shaped muscle separating the thoracic and abdominal cavities which helps control breathing

Inhalation – the diaphragm presses the abdominal organs forward and downward, thus increasing the space in the thoracic cavityAir rushes into the lungs

Exhalation – the diaphragm rises and recoils to the resting position, decreasing the amount of space in the thoracic cavityAir is pushed out of the lungs

Responsible for performing the major work of bringing atmospheric air into the lungs

Key Points-Mild Airway Obstruction

Good air exchangeThe victim can respond and cough forcefullyThe victim may wheeze between coughs

Rescuer’s ActionIf the victim is able to cough forcefully, the rescuer

does nothing but encourage the victim to continue coughing

Stay with the victim and monitor their conditionIf the mild airway obstruction persists, call 911.

Key Points-Severe Airway Obstruction

May be unable to speak – air cannot get in or out of the lungs

Weak, ineffective cough, or the inability to coughHigh pitched noise while inhaling or no noise at all

Cyanosis – it is a sign of lack of 02 in the bodyUniversal choking sign – clutching the neck with thumbs and fingers, visibly panicking

Rescuer’s Action – Severe Airway Obstruction

*Ask the victim if he/she is choking*If they nod yes and cannot talk, activate the

emergency response system – CALL 9-1-1

Child or Adult Over Age 1Heimlich maneuver

Stand or kneel and wrap your arms around the victim’s waist

Make a fist with one handPlace the thumb side of your fisted hand

just above the umbilicusPut your other hand over your fisted handUsing the strength of both hands, press

your fist into the victim’s abdomen with a quick upward thrustThis pushes the diaphragm upwardCreates an artificial cough

Repeat thrusts until obstruction is expelledVictim may become unresponsive

Unresponsive adult or childIf your choking victim becomes unresponsive:

Let the victim slide down your body to the floorTry to prevent the victim’s head from hitting the floorYou should have already called 9-1-1

Now you have an unconscious victim whom you know is unconscious because he/she was choking

Open the airway, if you see the object, remove itIf the victim does not start breathing, give 2 rescue

breaths and check for a pulseIf they have a pulse, continue rescue breathing until EMS

arrivesIf thy do not have a pulse, begin the steps of CPR

Unresponsive adult or childUnable to see the obstruction

Begin the steps of CPRLook for the object every time you open the airway to give

breathsDon’t put your fingers in their mouth unless you see the

objectContinue CPR until EMS arrives

Post Heimlich Maneuver

Recovery Position:Laying on their left side – allows for vomit to fall out of their

mouth and not back down their throatMedical Attention:

Encourage the victim to seek medical attention Possible damage to internal organsPossible cracked ribs

Obese or Pregnant Choking VictimsIf you cannot get your arms around the

victim, you may perform chest thrusts instead of abdominal thrustsStand or kneel and wrap your arms

around the victim’s chestMake a fist with one handPlace the thumb side of your fisted hand

in the middle of the chest, between the nipples

Put your other hand over your fisted handUsing the strength of both hands, press

your fist into the victim’s chest with a quick upward thrust.

Repeat until the obstruction is expelled from their airway

Responsive Choking Infant1. Sit with the infant on your lap2. Resting the baby on your forearm, hold

the infant prone with the head lower than the chest

3. Support the baby’s head and jaw with your hand

4. Rest your forearm on your lap or thigh to support the baby

5. Deliver 5 back slaps to the infanta. Slaps must be delivered forcefully in the

middle of the back, between the baby’s shoulder blades

b. Use the heel of your hand to deliver the slaps (glancing blows)

c. Each slap should have sufficient force to attempt to dislodge the foreign body

Responsive Choking Infant6. Place your free hand on the infant’s back, supporting the baby’s head with the palm of your hand.7. Carefully cradle the infant between your forearms, with the head supported, and turn the baby on his/her back.8. Keep the infant’s head lower than his/her trunk9. Give 5 downward chest thrusts in the same location as chest compressions10. Repeat the sequence until the object is removed, or the infant becomes unresponsive

Unresponsive Choking InfantStop giving back slaps once the infant become

unresponsiveBegin the steps of CPR

Look for the object each time you give breaths – if you see it, remove it. DO NOT perform a blind finger sweep

After about 2 minutes of CPR (5 cycles), activate the EMS system if you have not already done so.

Continue CPR until EMS arrives to take overInfant is revived:

Continue to monitor until EMS arrivesThe recovery positions is NOT recommended for infants and

small children